Healthcare Provider Details

I. General information

NPI: 1801128012
Provider Name (Legal Business Name): JAMES KEVIN JONES PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2010
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NMRTC CAMP PENDLETON 4TH FLOOR, RM 4172
CAMP PENDLETON CA
92055
US

IV. Provider business mailing address

31537 RANCHO PUEBLO RD STE 102
TEMECULA CA
92592-4841
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-1288
  • Fax:
Mailing address:
  • Phone: 833-867-4642
  • Fax: 360-462-2751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number58750
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: